Public-Private Organizations Behaviour: the Paradoxes in the Implementation of Ghana’s Health Insurance Scheme

Organizations public or private have their interests to pursue in public policies. Individuals in organizations are driven by visions and missions of their organizations and they work towards them. This paper has three contributions. First, to add public organizations perspective on public service delivery in developing world context. Also, to explain why organizations do behave (so differently between public and private) and motivations for such behaviour. It adds to the extant literature on how frontline workers behaviour and actions facilitate or inhibit public service delivery. Finally, it looks at the relationship between organizations (frontline workers) and their public (citizens or clients) in public service delivery process in the context of what this study called ‘cold’ and ‘hot’ relationships. The findings suggest two ways of solving the challenges between public and private organizations in public service delivery through redefining of organizations visions, missions and culture. The findings are presented along with the public-private organization paradoxes in implementation of National Health Insurance Scheme. The study established three relationships namely public-private organizations, superior-subordinate, and frontline workers- clients’ relationships. The frontline workers-clients relationship had stronger explanatory power in public service delivery in Ghana.